Hoarding Disorder And Depression

Introduction

A person with a hoarding disorder accumulates an excessive quantity of things and keeps them in an unorganised way, which typically leads to uncontrollable clutter. The objects may be worth nothing or very little money.¹

However, depression is a common but significant mood condition (sometimes known as major depression, major depressive disorder, or clinical depression). It produces severe symptoms that interfere with a person's ability to function in daily tasks like sleeping, eating, and working.²

In 1996, the term "hoarding" was used to describe a behavioural pattern in which people acquire goods but fail to get rid of them.⁶

What is hoarding disorder?

Definition 

According to the American Psychiatric Association, people with hoarding disorders have a difficult time getting rid of or parting with possessions. Usually when attempting to part with possessions, people with this condition experience great emotional distress and opt for keeping those items. As a result, living environments become difficult to use as they become extremely cluttered. 

Collecting is different from hoarding. The majority of the time, collectors make planned, deliberate, and specific purchases. Once obtained, the items are taken out for regular use but may be arranged, enjoyed, and presented to others.³ 

Although the World Health Organization added hoarding disorder as a new category within OCD (Code: 42.3) in 2017, the International Classification of Diseases (ICD) still does not identify hoarding disorder separately in ICD-10.⁴

Symptoms and behaviours associated with hoarding disorder

Important indicators of hoarding are:⁷

1. Having problems parting with possessions even if they aren't valued in prospective future demands
2. An intense and persistent emotional distress after getting rid of items
3. Cluttered living spaces

Hoarding leads to clinically substantial distress or impairment in social, occupational, or other key aspects of functioning, such as maintaining a space that is secure for oneself or others.⁵

Hoarding symptoms are thought to begin at a mean age of 13.4 years, with 60% of patients claiming that they first appeared by age 12 and escalating to 80% by age 18.⁸ 

What is depression?

Depression is a common but significant mood condition (sometimes known as major depression, major depressive disorder, or clinical depression). It produces severe symptoms that interfere with a person's ability to function in daily tasks like sleeping, eating, and working.² 

Major depression greatly restricts psychosocial functioning and lowers quality of life. According to WHO, major depression was the third leading cause of disease globally in 2008 and is expected to overtake all other diseases by 2030.⁹

Definition and criteria for depression

The following criteria are listed in the DSM-5 as necessary to diagnose depression. A minimum of five symptoms must be present for at least two weeks, and at least one of those symptoms must be either (1) a sad mood or (2) a lack of interest or pleasure.¹¹

Symptoms and behaviours associated with depression

You may have depression if you have been exhibiting some of the following signs and symptoms for at least two weeks, most of the day, almost every day:²

• Persistent sadness, anxiety, or feeling "empty"
• Emotions of despair or pessimism
• Feelings of unease, agitation, or irritability
• Guilt, worthlessness, or powerlessness sentiment
• Loss of enjoyment or interest in past interests or pursuits
• Reduced energy, tiredness, or a sense of slowness
• Having trouble focusing, remembering, or deciding
• Having trouble falling asleep, waking up early, or oversleeping
• Appetite changes or unintended weight fluctuations
• Thoughts of death or attempts at suicide
• Physical aches or pains, headaches, cramps, or digestive issues that do not have a clear physical cause and do not improve with treatment

The link between hoarding disorder and depression

According to 2011 research, over 50% of those with hoarding problems have been given a depression diagnosis. Furthermore, a 2019 study found greater rates of comorbidity between hoarding disorder and anxiety and mood disorders.¹³

How hoarding disorder can contribute to depression

As a result of the hoarding behaviours, people with hoarding disorders may also feel sadness, anxiety, and embarrassment, all of which can lead to depression. Feelings of helplessness and hopelessness, which are typical signs of depression, can be brought on by the stress brought on by living in a cluttered and disorganised environment.

Hoarding problems can also result in the loss of a viable living area, which can make it challenging to carry out daily activities like cooking, cleaning, and socialising. Depression symptoms can also be exacerbated by this decline in independence and the resulting reliance on others.⁷

In addition, hoarding affects the social development of children and can make family members angry, resentful, and depressed. Unlivable circumstances can result in separation or divorce, eviction, and even the loss of parental rights. Additionally, hoarding may cause severe financial difficulties.¹⁴

Hoarding problems can, in general, negatively affect a person's mental health and lead to the onset of depression. Therapy, medication, and/or practical measures like decluttering and organisation techniques may all be used to treat hoarding disorder.

How depression can contribute to hoarding disorder

Multiple factors, including depression, can influence how hoarding disorder develops. Low energy and drive are common symptoms of depression, which can make it difficult to keep a neat home. They might also feel emotionally attached to their possessions, which makes it difficult for them to get rid of things.

Additionally, anxiety and worry reactions brought on by depression may result in hoarding as a coping mechanism. Finally, sadness can result in a lack of social connections and support, which can make hoarding behaviours worse because people may rely on their belongings for solace and company.⁷

Treatment options for hoarding disorder and depression

Medication options for depression

Antidepressant medications are frequently prescribed as treatments, but they aren’t always beneficial. Other forms of therapy are starting to emerge, ranging from implanted devices that shock the brain with electrical pulses to hallucinogenic substances like psilocybin.¹⁰

Therapy options for hoarding disorder and depression

Although research on hoarding treatments is expanding, several therapy approaches have been shown to lessen the symptoms of hoarding.

Cognitive behavioural therapy (CBT)

In addition to assisting with clutter reduction, cognitive behavioural therapy (CBT) enables patients to address the ideas that underlie hoarding behaviour.

Research suggests that when a peer-led CBT group using exercises from the workbook "Buried in Treasure" was compared to a psychologist-led CBT group, Trusted Source observed a 22% improvement in hoarding behaviours overall.¹²

Lifestyle changes that can help manage both disorders

Numerous lifestyle modifications can help manage depression and hoarding disorder. Regular exercise has been demonstrated to elevate mood and lessen the effects of depression, making it one of the most effective management options. Exercise can also aid those with hoarding disorder in creating routines and boosting their motivation. 

Another crucial improvement is practising regular sleep hygiene measures, such as maintaining a consistent bedtime and avoiding devices before sleep. A regular sleep schedule can help control symptoms of depression and enhance focus, making it simpler to engage in decluttering and organization. Finally, learning healthy coping skills like deep breathing exercises and mindfulness meditation can help people manage their stress and anxiety, which can help them resist hoarding impulses.¹⁵

Summary

Greater efforts are needed to enhance major depression's diagnosis and care since it affects so many people, has a significant impact on each person, and imposes a big financial cost.

Both depression and hoarding disorders may be correlated. Additionally, both illnesses can be managed with regular exercise, stable sleep patterns, and appropriate coping techniques.